Lyme Disease

Below is an interesting link to a thorough discussion on gammaretroviruses and the related human endogenous retroviruses ERV’s of which there are 2,000 ERV genes located on a single human chromosome. There are thousands of ERV’s spread across the entire human DNA grouped into 24 families. XMRV has 95% homology with human ERV’s. What is very interesting about ERV’s and likely true for XMRV is that they are TH1 immunosuppressive which is believed to be critical in the ability to get pregnant as the mother needs to be Th1 immunosuppressed to avoid rejection of the implanted fetus. The hormones of pregnancy and especially progesterone are in part responsible for activating env proteins of ERV’s which apparently are largely responsible for this immunosuppression. It is likely that progesterone activates XMRV env protein and may explain why we see women with more CFS at 4 to 1 over men and the apparent vulnerability of adolescent girls to CFS onset and the relative reduction of the point prevalence of CFS in the elderly and in children compared to the young to middle ages. I have also observed a reduction in severity of CFS symptoms in post-menopausal women though perhaps modulated by their use of HRT. The related hormones to progesterone are pregnenolone and cortisol. I have seen both devastate a handful of CFS cases.

Two opposing physician views see hormone problems in CFS like two trains passing in the night going in opposite directions to get to the same place. Some see a hormone problem in CFS and attack it with hormone therapy and believe that is the solution to CFS or at least beneficial. Others see a hormone problem as more of an adaptation to solve a deeper problem. Correcting or subverting this adaptation creates bigger problems down the road for CFS.

To me, CFS is best viewed as a very complex terrain issue and that microbes are simply taking advantage of this fact so that reductionism to drugs or pharmaceuticals directed against single agents or pathways will be a poor therapeutic choice except perhaps early in the illness and in the occasional patient who is much less complex.